Migraine is surprisingly common, with approximately one in four women and one in twelve men developing migraine at some stage of their life. It generally first develops in childhood or as a young adult.
Attacks can vary from person to person with some people suffering from frequent attacks several times a week and others suffering attacks only every now and again.
It is possible for the attacks to cease later in adult life but for some people the attacks persist throughout life.
What are the types and symptoms of migraine?
Migraine can be split into two main types of attack; migraine attack without aura (commonly referred to as common migraine) and migraine attack with aura (commonly referred to as classic migraine).
Migraine without aura
This is the most common type of migraine attack and can be categorized by the following symptoms:
The Headache is usually on just one side of the head, typically the side or front, although it can start on one side and spread all over the head. The pain is commonly described as pulsating or throbbing and is moderate to severe. It often begins early in the day, but, can occur at any time of night or day and gradually gets worse with a peak time 2-12 hours after the initial pain. The headache can last anywhere from 4 to 72 hours.
Other common symptoms include: nausea, vomiting, irritable around bright light or loud noises, feeling the need to lie down in a dark room.
Less common symptoms include: blurred vision, inability to concentrate, loss of appetite, diarrhea, stuffed nose, frequent use of the toilet, sweating, abdominal pain, tender scalp, sensitivity to hot or cold.
Migraine with aura
Around one in four migraine suffers have migraine with aura. The symptoms are the same as listed above for migraine without aura but also include an aura (warning sign) before the headache begins.
Visual aurais the most common aura that is experienced. This can involve temporary and partial loss of vision, seeing flashes of light or objects appearing to boil, shake or rotate.
Numbness and pins and needles are the second most common aura experienced. Generally numbness begins in the hand, travelling up the arm and into the face, lips and tongue.
Other auras include: problems with speech, food cravings, odd smells, a feeling of wellbeing, experiencing other odd sensations.
Before suffering from migraine it is possible to experience just one aura or several, one after the other. Each aura will generally only last a few minutes but have been known to last up to an hour. The aura will disappear just before the headache begins, often a matter of minutes. It is possible for the aura to occur without a headache following but this is uncommon. Most sufferers of migraine with aura also have episodes of migraine without aura.
Other types of migraine
There are various, less common, types of migraine that people can suffer from such as:
What causes migraine?
It is currently unclear as what the exact causes of migraine are and why they occur, however, it thought that certain things may trigger migraine attacks. There are all sorts of triggers such as:
- Diet – Eating irregular meals, dieting too quickly, cheese, chocolate, citrus fruits, red wine and food containing tyramine (a food additive) can all trigger migraines.
- Environment – Glaring lights, flickering TV sets, smoky rooms, loud noises and strong smells have all been known to trigger migraines.
- Medicines – Sleeping tablets, hormone replacement therapy and the contraceptive pill have been associated with migraine attacks
- Psychological – Stress is a leading cause of migraine along with anxiety, anger, tiredness, depression and other causes of stress.
- Other – There are many other triggers such as irregular sleeping patterns, shift work, periods and the menopause.
The best way to try and reduce migraine attacks is to keep a diary detailing when and where each attack started and try to trace what you had been doing, eating etc. before the attack began. By doing this you may find a pattern emerging and avoid the common trigger for your migraine attacks.
What are the treatments for migraine?
There is no specific medication available for migraine as the causes are variable and not fully understood, however, the following treatments have been known to work well for migraines:
Paracetamol or aspirin are the most popular treatment for sufferers of migraine. It is best to take a dose as early as possible to help reduce the severity of the headache or even stop it completely. Many people don’t take a painkiller until the headache has become very severe and this can often lead to the painkiller not working.
When taking the painkiller use a full dose and repeat every four hours if necessary. It may be best to use soluble tablets as they are absorbed much quicker than solid tablets.
Anti-inflammatory painkillers are known to work better than paracetamol due to the fact they contain ibuprofen. It is possible to buy ibuprofen over the counter at pharmacies or you could use prescription medication such as naproxen, diclofenac or tolfenamic acid.
Combination of medicines
For people who feel nauseous when suffering from a migraine attack, tablets containing both a painkiller and anti sickness medicine may be the best option. Examples of these are Migraleve, Paramax and MigraMax. If the dose of these isn’t strong enough you may prefer to take painkillers and anti sickness medicine separately.
Triptan medicines are an alternative if the painkillers aren’t helping and include almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan. It is important to note these are not painkillers and work by interfering with a brain chemical called 5HT. It is believed an alteration in this chemical is involved in migraine and a triptan can help to reduce or abort a migraine attack.
Migraines are a significant source of lost productivity in the workplace and medical costs. It has been estimated that migraines are the most costly neurological disorder, costing in excess of $17 billion. Almost a tenth of this cost is due to triptans and $15 billion of indirect costs such as missed work.
People who attend work with a migraine generally only work at two-thirds of their usual productivity and migraines have been known to cause negative impacts on a person’s family life also.